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Anatomy > GI > Flashcards

GI Flashcards

1
Q

Name the four quadrants of the abdomen.

A

Right upper
Left upper
Right lower
Left lower

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2
Q

What lines divide the abdomen into the 4 quadrants?

A

Transumbilical line and median line

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3
Q

What are the 9 regions of the abdomen?

A 
Right hypochondriac
Epigastric
Left hypochondriac
Right lumbar
Umbilical
Left lumbar
Right iliac fossa
Suprapubic
Left iliac fossa
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4
Q

What lines are used to divide the abdomen into 9 regions?

A

Right and left mid-clavicular
Transtubercular
Subcostal

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5
Q

What is within the right hypochondriac region?

A

Liver

Gall bladder

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6
Q

What is within the epigastric region?

A

Stomach
Liver
Oesophagus
(Transverse colon)

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7
Q

What is within the left hypochondriac region?

A

Spleen

Pancreas

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8
Q

What is within the right lumbar region?

A

Ascending colon
Small intestine
Right kidney
Gall bladder

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9
Q

What is within the umbilical region?

A

Small intestine

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10
Q

What is within the left lumbar region?

A

Descending colon
Small intestine
Left kidney

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11
Q

What is within the right iliac fossa region?

A

Caecum
Appendix
Small intestine

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12
Q

What is within the suprapubic region?

A

Small intestine
Rectum
Sigmoid colon

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13
Q

What is within the left iliac fossa region?

A

Small intestine
Descending colon
Sigmoid colon

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14
Q

What are the abdominal wall muscles?

A

External oblique
Internal oblique
Rectus abdominis
Transversus abdominis

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15
Q

What is the action and innervation of the external oblique muscles?

A

Compress and support abdominal viscera, flex/rotate trunk

Anterior rami T7-11 and subcostal nerve

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16
Q

What is the action and innervation of the internal oblique muscles?

A

Compress and support abdominal viscera, flex/rotate trunk

Anterior rami T7-11, subcostal nerve, 1st lumbar

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17
Q

What is the action and innervation of the transversus abdominis muscles?

A

Compress and support abdominal viscera

Anterior rami T7-11, subcostal nerve, 1st lumbar

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18
Q

What is the action and innervation of the rectus abdominis muscles?

A

Flexes trunk and compresses abdominal viscera, controls tilt of pelvis

Anterior rami T7-11 and subcostal nerve

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19
Q

What is the difference in arrangement of abdominal muscles above and below the level of the umbilicus?

A

Above the umbilicus the rectus sheath is incomplete whereas below it is complete

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20
Q

Which additional muscle exists in vertical orientation anteriorly in the abdomen? What is it’s action?

A

Pyramidalis - lies in rectus sheath, anterior to inferior rectus abdominis

Tenses linea alba

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21
Q

What is the rectus sheath? What is it made up of?

A

An aponeurosis which encloses the rectus abdominis

Made of aponeuroses of;

  • internal oblique
  • external oblique
  • transversus abdominis
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22
Q

What is an aponeurosis?

A

thin, fibrous structure attaching muscles to bone or cartilage

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23
Q

What thoracic spinal segments innervate the anterior abdominal wall?

A

Anterior rami T7-11 and subcostal nerve

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24
Q

How does the inguinal canal form?

A

It forms during relocation of the gonads during foetal development. It is formed from layers of the anterior abdominal wall as they push through the wall obliquely forming a canal.

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25
Q

Which bony points does the inguinal canal attach to?

A

Anterior superior iliac crest and the pubic tubercle (~4cm long)

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26
Q

Name the walls, roof and floor of the inguinal canal

A

Anterior wall; external oblique aponeurosis

Posterior wall; transversalis fascia

Roof; musculo-aponeurotic arches (internal oblique and transvesalis)

Floor; inguinal ligament

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27
Q

What are the openings for the inguinal canal?

A

Deep inguinal ring (superiorly)

Superficial inguinal ring (inferiorly)

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28
Q

What are the superior and inferior epigastric vessels branches of?

A

Superiorly; internal thoracic artery and vein

Inferiorly; external iliac artery and vein

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29
Q

What are the contents of the inguinal canal?

A

MALE; spermatic cord, blood and lymphatic vessels, ilio-inguinal nerve

FEMALE; round ligament of uterus, blood and lymphatic vessels, ilio-inguinal nerve

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30
Q

What are the histological layers of the gut (from oesophagus to anus)?

A

Mucosa; epithelium, lamina propria, muscularis mucosae

Submucosa

Muscularis Propria

Serosa/Adventitia

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31
Q

What are the basic mucosal types in the GI tract?

A

Protective - oral cavity, pharynx, oesophagus, anal canal

Secretory - stomach ONLY

Absorptive - entire small intestine

Absorptive/Protective - entire large intestine

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32
Q

What are the subdivisions of peritoneum?

A

Parietal and visceral

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33
Q

What are the divisions of the peritoneum? through what do these communicate?

A

Greater sac and lesser sac

Epiploic foramen (posterior to free edge of lesser omentum)

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34
Q

What is the meaning of intraperitoneal and retroperitoneal?

A

Intraperitoneal - completely surrounded by visceral peritoneum

Retroperitoneal - firmy attached to posterior wall i.e. only anterior surface covered in visceral peritoneum

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35
Q

What are some intraperitoneal and retroperitoneal organs?

A

Intraperitoneal - stomach, spleen, liver, transverse and sigmoid colon

Retroperitoneal - duodenum, kidneys, pancreas, ascending and descending colon

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36
Q

What is present in the peritoneal cavity?

A

Peritoneal fluid (NO ORGANS)

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37
Q

Which layer of peritoneum is more sensitive to pressure, pain, heat and cold?

A

Parietal

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38
Q

What are the attachments of the greater and lesser omenta?

A

Greater; greater curvature of stomach to transverse colon

Lesser; lesser curvature of stomach to liver

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39
Q

What is pain in parietal and visceral peritoneum innervated by?

A

Parietal innervated by T7-12 and L1, so pain is somatic and can be precisely localised

Visceral innervated by autonomic nerves so pain is often referred, dull and poorly localised (PAIN REFERRED TO MIDLINE)

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40
Q

What are the posterior abdominal wall muscles and their attachments?

A

Psoas major - T12, L1-5 vertebrae then enters thigh

Psoas minor - overlies psoas major and gives way to long narrow tendon

Iliacus - fan shaped, upper portion of abdominal surface of ileum, inner side of thigh bone; lesser trochanter

Quadratus lumborum - posterior border of iliac crest, twelfth rib

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41
Q

What is the function and innervation of Psoas major?

A

Flexion and medial rotation of the hip joint, flexes lumbar spine both anteriorly and laterally

Anterior rami of upper lumbar nerves

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42
Q

What is the function and innervation of the iliacus muscle?

A

Assists psoas major in flexing hip joint

Femoral nerve

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43
Q

What is the function and innervation of quadratus lumborum?

A

Lateral flexion of lumbar spine

Subcostal nerve and anterior rami of upper 3 lumbar nerves

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44
Q

What is the arcuate line?

A

The demarcation of the lower limit of the rectus abdominis muscle

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45
Q

What are the 3 openings in the diaphragm?

A

T8 - caval

T10 - oesophageal

T12 - aortic

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46
Q

What are the 3 main branches of the abdominal aorta supplying blood to gut tube and at what vertebral level do these occur?

A

Coeliac trunk - T12
SMA - L1
IMA - L3

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47
Q

How does the IVC form in the abdomen?

A

By the union of the common iliac veins

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48
Q

What are the foregut structures?

A

Abdominal oesophagus
Duodenum
Stomach

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49
Q

What are the midgut structures?

A 
Jejunum
Ileum
Ascending colon
2/3 transverse colon
(part of duodenum)
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50
Q

What are the hindgut structures?

A

1/3 transverse colon
Descending colon
End of transverse colon
Sigmoid colon

51
Q

Which vessels supply foregut, midgut and hindgut?

A

Foregut; coeliac
Midgut; SMA
Hindgut; IMA

52
Q

What forms the portal vein?

A

The union of the splenic vein and the SMV

53
Q

What are the sites of portocaval anastomoses in the body? What is the clinical significance of these?

A

Distal oesophagus
Between rectal veins
Paraumbilical veins
Bare area of liver

Clinical significance; allow portal venous system to communicate with systemic venous system

54
Q

What is the sympathetic neural supply to the abdominal viscera?

A

Abdominopelvic splanchnic nerves (greater, lesser and least)

Prevertebral sympathetic ganglia

Abdominal aortic plexuses

55
Q

What is the parasympathetic neural supply to the abdominal viscera?

A

Anterior and posterior vagal trunks

Pelvic splanchnic nerves (S2, S3, S4)

56
Q

Effect of nervous system on

a) GI secretion
b) peristalsis/GI motility
c) blood vessels

A

Parasympathetic a) stimulates

                         b) stimulates
                         c) vasodilation

Sympathetic a) inhibits

                  b) inhibits
                  c) vasoconstriction
57
Q

What effect does vagotomy have on gastric secretion?

A

Reduces gastric secretion as the vagus nerve would be parasympathetic and thus would normally stimulate gastric secretion

58
Q

Functional difference between greater, lesser and least splanchnic nerves and the pelvic splanchnic nerves

A

Greater, lesser and least are sympathetic

Pelvic are parasympathetic

59
Q

At what level do the kidneys lie?

A

T12-L3

60
Q

What are the three main structures leaving the hilum of the kidney (in their anterior to posterior arrangement)?

A

Renal vein
Renal artery
Ureter

61
Q

Where are the suprarenal (adrenal) glands located and what type of gland are they?

A

Between superomedial aspect of kidneys and diaphragmatic crura

Endocrine (into bloodstream)

62
Q

What is the expanded upper part of the ureter?

A

Renal pelvis

63
Q

Where is the ureter constricted?

A
  • at junctions of ureters and renal pelvis
  • where ureters cross rim of pelvic inlet
  • during passage through urinary bladder wall
64
Q

What is the blood supply, venous drainage and lymphatic drainage of the oesophagus?

A

Blood supply; branches of left gastric artery

Venous drainage; portal system and azygous vein to systemic system

Lymphatic drainage; drain into deep cervical nodes and superior and posterior mediastinal nodes

65
Q

What are the parts of the stomach?

A 
cardia
fundus
body
antrum
pylorus
66
Q

What is the pyloric sphincter and what is its function?

A

band of muscle surrounding the exit from stomach to duodenum

acts as a ‘valve’ to control flow of partially digested food into small intestine

67
Q

In what portions of the stomach are rugae most apparent?

A

Body and antrum

68
Q

What structures does the stomach lie on?

A 
Left dome diaphragm
Pancreas
Spleen
Left kidney
Left suprarenal gland
Colon
Transverse mesocolon
69
Q

What are the three parts of the small intestine?

A

Duodenum
Jejunum
Ileum

70
Q

What is the ampulla of Vater?

A

the opening of the bile duct and pancreatic duct into the duodenum at the major duodenal papilla

71
Q

In which part of the small intestine are there many arterial arcades?

A

Ileum

72
Q

What are some important features of large intestine?

A

Teniae coli and haustra

Omental appendices

73
Q

Which two structures open into the cavity of the caecum?

A

Ileum and appendix

74
Q

What is McBurney’s point and why is it useful clinically?

A

Right side of abdomen, 1/3 distance from anterior superior iliac spine and navel

Most common location of appendix

75
Q

What is the arterial supply and venous drainage of the superior, middle and inferior rectum?

A

Superior - superior rectal artery and vein

Middle - middle rectal artery and vein

Inferior - inferior rectal artery and vein

76
Q

How is the rectum peritonised?

A

Inferior 1/3 is extraperitoneal, rest is retroperitoneal

77
Q

What is the difference between the visceral and somatic innervation of anal canal?

A

Visceral - sensitive to stretching

Somatic - sensitive to pain

78
Q

What is the falciform ligament and what structures lie within its free border?

A

Ligament attaching liver to body wall - ligamentum teres (round ligament)

79
Q

What is the round ligament a remnant of?

A

Umbilical vein

80
Q

What are the paracolic gutters?

A

spaces between colon and abdominal wall

81
Q

What kind of epithelium lines the oesophagus?

A

stratified squamous non-keratinised epithelium

82
Q

What secretory cells are present in the gastric pits?

A

mucous secreting cells - secrete mucus
Parietal cells - HCl and intrinsic factor
Chief cells - pepsinogens

83
Q

What are the folds extending into the small intestine called?

A

Plicae circulares

84
Q

What kind of surface epithelium do villi have?

A

Simple columnar

85
Q

What is the transpyloric plane? What structures are present in this plane?

A

plane halfway between suprasternal notch of manubrium and upper border of symphysis pubis

first part of duodenum, neck of pancreas, kidneys (hila), spleen (hilum)

86
Q

Which organ is examined in

a) barium meal
b) barium meal follow through
c) Barium enema

A

a) stomach
b) small intestine
c) large intestine and rectum

87
Q

What is the spleen and what is its function?

A

A lymphoid organ connected to the blood vascular system

It acts as a filter for blood and plays an important role in the immune responses of the body

88
Q

What are the areas of the spleen?

A

Gastric
Renal
Colic
Pancreatic

89
Q

How is spleen peritonised?

A

Intraperitoneal

90
Q

What are the structures in the hilum of the spleen?

A

Splenic artery
Splenic vein
Gastrosplenic ligament
Lymphatics

91
Q

How is the pancreas peritonised?

A

Retroperitoneal

92
Q

What are the parts of the liver?

A

Right and left lobes separated by falciform ligament

Caudate (superior) and quadrate (inferior) lobes

Left triangular ligament

Bare area lacking peritoneum

93
Q

What is the bare area of the liver?

A

Triangular area on diaphragmatic surface that is not peritonised

94
Q

What structures are present in the porta hepatis?

A

Portal vein
Left and right hepatic ducts
Left and right branches of hepatic artery

95
Q

What are the extrahepatic biliary apparatus?

A 
Right and left hepatic ducts 
Common hepatic duct
Cystic duct
Gall bladder
Common bile duct
96
Q

What is the function of bile?

A

To dissolve fat and fat soluble vitamins

97
Q

What are the boundaries of Calot’s Cystohepatic triangle and what is its clinical significance?

A

Cystic duct, common hepatic duct and inferior surface of liver

Care must be taken during cholecystectomy (gall bladder removal) because the triangle contains the cystic artery. It is important not to damage structures in and around the triangle.

98
Q

What is the surface marking of the gall bladder?

A

9th costal cartilage

99
Q

What ribs are related to the spleen?

A

9, 10 and 11

100
Q

Describe the obturator nerve

A

Originates from posterior divisions of L2, L3 and L4 spinal roots

travels medially along psoas major before entering obturator foramen (opening in pelvic bone) and passing into thigh

101
Q

What is the cysterna chyli?

A

A dilated sac at the lower end of thoracic duct into which lymph from intestinal trunk and two lumbar lymphatic trunks flows.

It passes through aortic hiatus (T12) in diaphragm.

102
Q

What is the clinical significance of the paracolic gutters?

A

Infected fluid can spread through these to other parts of the abdomen

103
Q

What is the lymphatic drainage of the stomach?

A

Suprapyloric lymph nodes
Inferior gastric subpyloric lymph nodes
Superior gastric lymph nodes
Pancreaticolineal lymph nodes

104
Q

What is the lymphatic drainage of the first part of the duodenum?

A

Celiac group of lymph nodes

105
Q

What is the lymphatic drainage of the second part of duodenum?

A

Pancreato-duodenal lymph nodes

106
Q

What is the lymphatic drainage of the jejunum and ileum?

A

Superior mesenteric group of lymph nodes

107
Q

What is the lymphatic drainage of the cecum and ascending colon?

A

Superior mesenteric group of lymph nodes

108
Q

What is the lymphatic drainage of the right 2/3rds of the transverse colon?

A

Superior mesenteric group of lymph nodes

109
Q

What is the lymphatic drainage of the left 1/3rd of the transverse colon?

A

Inferior mesenteric group of lymph nodes

110
Q

What is the lymphatic drainage of the sigmoid colon?

A

Inferior mesenteric group of lymph nodes

111
Q

Where is epiploic foramen in relation to the portal vein?

A

Posterior

112
Q

Where does the spleen develop?

A

Dorsal mesogastrium

113
Q

Where does part of the motor supply to the diaphragm come from?

A

Phrenic and lower intercostal nerves

114
Q

What are the kidneys embedded in?

A

Perirenal fat

115
Q

What is some of the skin of the scrotum supplied by?

A

Ilioinguinal nerve

116
Q

What vertebral level does the body of the pancreas lie at?

A

First lumbar vertebra

*receives branches from splenic artery

117
Q

What are some direct relations to the abdominal aorta?

A
  • left renal vein
  • anterior longitudinal ligament
  • left lumbar veins
118
Q

What peritoneum is related to the liver?

A
  • falciform ligament
  • left and right triangular ligaments
  • lesser omentum
  • hepatorenal recess
119
Q

What innervates psoas major?

A

upper lumbar nerves L1-3 anterior rami

120
Q

Innervation of liver

A

Hepatic neural plexus

  • sympathetic fibres from coeliac plexus
  • parasympathetic fibres from anterior and posterior vagal trunks
121
Q

Innervation of pancreas

A

Vagus nerve

Thoracic splanchnic nerve fibres from superior mesenteric and coeliac plexuses

122
Q

Innervation of stomach

A

Sympathetic from coeliac ganglion and splanchnic nerves supply blood vessels and musculature

Parasympathetic travel in gastric branches of vagus

123
Q

Kupffer cells

A

Specialised liver macrophages, lining walls of sinusoids

Form part of mononuclear phagocyte system, constitute 80-90% macrophages in the body

Anatomy (10 decks)

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